Abstract
Background: Childhood blindness is a major public health concern since 40% of visual disorders that can cause blindness among children are preventable. Vision screening programs among preschool children have been implemented in several countries as a tool for early detection and intervention of visual disorders. In Palestine, there is a lack of scientific data on the prevalence of visual disorders among children. In addition, vision-screening programs that are currently implemented are neither validated nor effective. Objective: Using validated vision screening protocols, a cross-sectional study is conducted to determine the prevalence of visual disorders among urban Palestinian preschool children between the ages of 3 to 5 years in Nablus city. Methods: All children attending eight preschools selected using single-stage cluster sampling technique, underwent a validated vision screening administered by trained eye care professionals. The screening protocol was based on a combination of clinical assessment adopted from the Modified Clinical Technique and the Vision in Preschoolers studies, including assessment of visual acuity, ocular alignment, depth perception, color vision, non-cycloplegic retinoscopy, and ocular health. A pass-fail criterion was used to refer all children who did not attend the vision screening for comprehensive eye examination, including cycloplegic retinoscopy and a dilated fundus exam. A chi-squared test was used to determine any association between visual disorders and their independent risk factors. Results: A total number of 764 children underwent vision screening. Out of the 290 children who did not attend the vision screening, 127 children responded to the referral call for comprehensive eye examinations. Refractive error was the most prevalent visual disorder with a prevalence of (29.37%), followed by amblyopia (4.10%), color vision deficiency (1.24%), strabismus (1.24%), and ocular health abnormalities (0.70%). There was no age (p=0.35) and gender (p=0.32) variation in children having refractive errors. Anisometropia was the leading cause for amblyopia (1.32%, n=7), followed by significant refractive error (1.13%, n=6) and strabismus (0.37%, n=2). Conclusion: Refractive error was the most prevalent visual disorder affecting Palestinian preschoolers in Nablus. Anisometropia and significant refractive errors were found to be the major causes of amblyopia. Effective nationwide preschool vision screening programs should be implemented in Palestine to screen amblyogenic risk factors.
Highlights
It has been estimated that 1.4 million children (0-14 years) are blind worldwide, and 19 million children are visually impaired [1]
Out of the 290 children who did not attend the vision screening, 127 children responded to the referral call for comprehensive eye examinations
Anisometropia and significant refractive errors were found to be the major causes of amblyopia
Summary
It has been estimated that 1.4 million children (0-14 years) are blind worldwide, and 19 million children are visually impaired [1] This is a major public health concern, especially. In the United States, a descriptive study reporting statistics estimated based on prevalence data from 2 major population-based studies reported that approximately 69% of preschool children aged 3-5 years were visually impaired due to refractive error, and 25% due to bilateral amblyopia [6]. The overall rate of amblyopia in the United States has been reported to be at 2% to 3%, well above what it could be if efficient and effective vision screening programs are implemented [8, 9]. Vision screening programs among preschool children have been implemented in several countries as a tool for early detection and intervention of visual disorders. Vision-screening programs that are currently implemented are neither validated nor effective
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